脂必泰与阿托伐他汀疗效及安全性对比研究  

A comparative study of the efficacy and safety Zhibitai and atorvastatin

作　　者：许丹焰[1] 舒君[1] 黄全跃[1] 刘玲[1] 赵水平[1] 

机构地区：[1]中南大学湘雅二医院心内科,长沙410011

出　　处：《中华内科杂志》2010年第5期392-395,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金（30770856）;教育部新世纪优秀人才支持计划（NCET-08-0566）;中南大学代谢与内分泌研究所基金（DY-2008-02-04）

摘　　要：目的 比较强化脂必泰及阿托伐他汀治疗对血脂异常的冠心病中、高危患者的调脂、抗炎疗效及安全性.方法 血脂异常的冠心病中、高危患者169例,随机分为脂必泰组和阿托伐他汀组.于治疗前及治疗后4周、8周分别检测高敏C反应蛋白（hs-CRP）、P-选择素、基质金属蛋白酶（MMP）-9和可溶性细胞间黏附因子-1（SICAM-1）等.结果 与治疗前比较,治疗后4、8周两组TC、LDL-C显著下降,HDL-C升高.脂必泰组治疗4、8周后TG从（2.22±0.62）mmol/L分别下降至（2.05±0.70、1.77±0.75）mmol/L（P〈0.05）;而他汀组治疗4周与治疗前比较TG无显著下降,治疗8周后TG显著下降[（2.28±0.61）mmol/L～（1.79±0.66）mmol/L,P〈0.05];与治疗前相比,两组治疗8周后P-选择素、MMP-9、SICAM-1、hs-CRP等炎症因子较治疗前均明显降低（各组P值均〈0.01）,两组治疗前后肝肾功能、肌酶变化、肌病发生率和消化道反应发生率差异无统计学意义（P〉0.05）.结论 强化脂必泰治疗能有效调脂并降低血脂异常患者的炎症因子,且临床应用安全.Objective To compare the lipid lowing effect and the clinical safety between intensive therapy with Chinese medicine Zhibitai and atorvastatin in patients with moderate and high risk of atherosclerosis. Methods All the patients were randomly divided in to a Zhibitai group （ n = 85 ） receiving 480 mg of Zhibitai orally twice a day or an atorvastatin group （ n = 84 ） receiving 10 mg atorvastatin orally once daily. Blood lipoproteins, myocardial enzymes, liver and renal function were measured before treatment and at the fourth and eighth week after therapy , while high sensitive creactive protein （hs-CRP）, P-seleetin,matfix-metall proteinase-9 （ MMP-9 ） and soluble intercellular adhering molecule-1 （ SICAM-1 ） were detected before treatment and eighth week after therapy in all patients. Results TC and LDL-C were significantly decreased while HDL-C was increased in both groups after 4 and 8 weeks treatment （P 〈 0. 05）. TG was decreased in Zhibitai group after 4 and 8 weeks of treatment, but it was decreased in atorvastatin group only after 8 weeks of treatment. Inflammatory factors such as hs-CRP, P-selectin,MMP-9, SICAM-1 were decreased significantly （ all P 〈 0. 01 ）, but there was no significant difference between the two groups. There were no difference in liver and kidney function, myocardial enzymes and incidence of muscle-ache and digestive system side reaction. Conclusions Besides the lipoprotein disorder, inflammatory factors in patients with moderate and high risk of atherosclerosis could be regulated with intensive therapy of Zhibitai. Most importantly, it is safe to use Zhibitai clinically.

关 键 词：血脂异常 炎症介导素类 脂必泰 

分 类 号：R541.4[医药卫生—心血管疾病]